Acute Postoperative Epidural Hematoma After Unilateral Biportal Endoscopic Laminotomy
Background
Acute postoperative epidural hematomas (PEDH) are serious complications that can occur after spinal surgeries, with reported incidences ranging from 0.1% to 3%. Understanding the etiology and management of these hematomas is crucial.
Data Highlights
Timepoint
VAS Score
JOA Score
Preoperative
6
10
Post-drain removal
10
N/A
Post-emergency debridement
3
N/A
Key Findings
A 56-year-old male developed acute PEDH after UBE-ULBD for L3-4 spinal stenosis.
The patient experienced severe pain (VAS 10) shortly after surgical drain removal.
MRI confirmed hematoma accumulation compressing the dural sac and nerve roots.
Emergency debridement revealed continuous bleeding from a small muscular artery.
Post-debridement, the patient's pain improved significantly (VAS 3).
This case represents the first documented instance of PEDH following UBE-ULBD surgery.
Clinical Implications
Surgeons should ensure meticulous hemostasis during UBE procedures to prevent complications such as PEDH.
Conclusion
This case highlights the potential for acute PEDH following UBE-ULBD.
Randomized trial finds a topical anti-inflammatory patch provided similar pain relief, function, and safety as oral therapy during the first 6 weeks after surgery.
